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©2013 UpToDate ® Print Email Asparaginase desensitization* Injection 1: Elspar® dose = 1 int. unit Accumulated total dose = 1 Injection 2: Elspar® dose = 2 int. units Accumulated total dose = 3 Injection 3: Elspar® dose = 4 int. units Accumulated total dose = 7 Injection 4: Elspar® dose = 8 int. units Accumulated total dose = 15 Injection 5: Elspar® dose = 16 int. units Accumulated total dose = 31 Injection 6: Elspar® dose = 32 int. units Accumulated total dose = 63 Injection 7: Elspar® dose = 64 int. units Accumulated total dose = 127 Injection 8: Elspar® dose = 128 int. units Accumulated total dose = 255 Injection 9: Elspar® dose = 256 int. units Accumulated total dose = 511 Injection 10: Elspar® dose = 512 int. units Accumulated total dose = 1023 Injection 11: Elspar® dose = 1024 int. units Accumulated total dose = 2047 Injection 12: Elspar® dose = 2048 int. units Accumulated total dose = 4095 Injection 13: Elspar® dose = 4096 int. units Accumulated total dose = 8191 Injection 14: Elspar® dose = 8192 int. units Accumulated total dose = 16,383 Injection 15: Elspar® dose = 16,384 int. units Accumulated total dose = 32,767 Injection 16: Elspar® dose = 32,768 int. units Accumulated total dose = 65,535 Injection 17: Elspar® dose = 65,536 int. units Accumulated total dose = 131,071 Injection 18: Elspar® dose = 131,072 int. units Accumulated total dose = 262,143 * Some practitioners perform an asparaginase desensitization regimen for patients who react to a test dose, or who are being retreated following a break in therapy. Doses are doubled and given every 10 minutes until the total daily dose for that day has been administered. The suggested schedule as outlined above begins with a total of 1 unit given IV and doubles the dose every 10 minutes until the total amount given is the planned dose for that day. For example, if a patient was to receive a total dose of 4000 units, he/she would receive injections 1 through 12 during the desensitization. Adapted with permission from: Merck and Co, Inc. Elspar (Asparaginase). Densitization regimen. Copyright ©2008 Merck and Co, Inc.